Pulmonary

Abstract

In this controlled, prospective study 30 ventilated premature infants with a birth weight < 1250 g were randomized to receive treatment with dexamethasone (DEX) either on day 7 of life or on day 14 of life. DEX was given over 16 days tapering from 0.5 mg/kg/day to 0.1 mg/kg/day. The infants treated with DEX on day 7 of life could be weaned earlier from the ventilator -in median after 14 days (range 10 -34) versus 24 days (range 8 -44) in the late treatment group (p = 0.01). The need for supplemental oxygen was shorter in the early treatment group -in median 24 days (range 10 -50) versus 40 days (range 10 -70) (p = 0.2, ns). The incidence of chronic lung disease was lower in the early treatment group -6 of 14 infants (42.9%) versus 10 of 16 patients (62.5%) (ns).To evaluate the long-term efficacy of early DEX treatment we performed a respiratory function test in the age of 3 -6 months using an infant whole body-plethysmograph. The intrathoracic gas volume (ITGV), the airway resistance (R aw ) and the airway conductance (Gaw) were measured and no significant differences could be detected between the groups. The frequency of adverse effects due to DEX therapy was found to be without significant differences between the early and the late treatment group. We conclude that early DEX treatment had short-term improvements in pulmonary outcome in our study population, long-term efficacy however, remained unproven.